To Unpathed Waters, Undreamed Shores

This blog post was contributed by Sara Al-Lamki, one of the fifteen Young Champions of Maternal Health chosen by Ashoka and the Maternal Health Task Force at EngenderHealth. This is her final post about her experience as a Young Champion, and you can learn more about her, the other Young Champions, and the program here.

The past nine months have been such a whirlwind. And, it has been an especially hectic past four weeks — I can’t believe that I am embarking on yet another adventure and I’m not sure where this one will take me.

Bali has taught me much and I have grown immensely from this experience — not just career-wise, but also as a person and as a woman. The realities of maternal health are very different when experienced in the field. Obstacles such as compliance, follow-up, and reaching the maximum number of women are far more difficult than one can imagine on paper. At YRS, outreach workers often have to run around the throngs of people in the market, because a woman has not come for her follow-up and the doctor needs to deliver news, sometimes bad news, and administer treatment. The struggle of convincing a woman to have an institutional birth, or to have a trained attendee with her at home, rather than have her husband deliver the baby, is much harder than you would think. Deep-rooted cultural and religious practices cannot be separated from the people and are present regardless of education, or socio-economic status. Though these customs are often very beautiful and symbolic, they can have indirect health consequences. The view that it is best to give birth where you yourself were born is a beautiful notion of continuity in life and culture; however, if that means delivering in an isolated community with little or no access to health care then the tradition makes it nearly impossible to get this woman the emergency care she may need. All of this is something struggled with on the ground, not portrayed on paper, and which is often forgotten or neglected by stakeholders.

The resilience and passion of my colleagues at YRS has been unbelievable. Against all odds, the clinic has been running for seven years, and is planning on growing and expanding. The plan is to reach eight other markets in Denpasar first, and then to have a similar market-based reproductive health centre in all districts of Bali within the next five years. Since it is such a great model, it is very possible. This has really shaped my own vision for maternal health. Seeing an unbiased view of what it is like to start up and run a small NGO in a conservative nation like Indonesia has made my head spin with ideas and plans for my own social venture in the future. The social and governmental politics of it, the challenges, but most of all the bond between the workers and the women they serve, has given me a clearer view of what my own future could look like. Walking through the market to get to the clinic, with women calling out to me Ibu Doctor! (Mrs Doctor) and running after me to tell me all their ailments is my favorite part of the day. It doesn’t matter if I’m a doctor or not. I work in the clinic, I’m running around interviewing different women and asking questions about pregnancy, I’m sitting next to the doctors and nurses every day — I must have a solution to their health problems! And if I don’t, they’re happy that I care, and that I listen intently, and recommend either a prompt visit to YRS or rest (depending on the symptoms, of course).

I’m still young, and new to the field, so my ideas and plans still need some nurturing to grow. I’m looking forward to connecting with innovators in the Arab world, spending time looking for projects in the Arabian Gulf, and talking to people about my ideas and getting them on board. The field has always focused on the countries with the highest mortality rates, and while the Arab states are thankfully hardly ever featured on this list, there are still women that die during childbirth, and many morbidities associated with childbirth. Also, there’s a large gap in health and community education, and women are lacking knowledge and empowerment. I want my venture to incorporate all these things, and start putting the Arab world on the map in terms of maternal health innovation.

It doesn’t sound like much of a plan yet, but as I’m sure most of you know, that is exactly how so many great social ventures are born. As I have said so many times in the past, I need to not get ahead of myself just yet, and plan it out one step at a time. If the next nine months are anything like the last, I can’t wait to start this new journey.

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The posts on this blog do not necessarily reflect the views of the Maternal Health Task Force. Our objective is to provide a platform for our Editorial Committee and other experts to post a myriad of data and evidence, as well as opinions/views that exist in the field which will contribute to expanding the maternal health dialogue.

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This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS) under grant T76MC00001 and entitled Training Grant in Maternal and Child Health. This information or content and conclusions are those of the author and should not be construed as the official position or policy of, nor should any endorsements be inferred by HRSA, HHS or the U.S. Government.